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ABC - Health News

New guidelines call for doctors to screen for anxiety: Why it matters, especially for women

Ghislain & Marie David de Lossy/Getty Images

(WASHINGTON) -- Jillian Hughes, 33, of Washington, D.C., said she dealt with symptoms of anxiety for more than a decade before getting a diagnosis of and treatment for anxiety disorder in her 20s.

Lanee Higgins, of Baltimore, remembers being labeled a "worrier" as a child, a label she said stuck with her all the way through this year, when, as a 30-year-old, she was diagnosed with generalized anxiety disorder, a condition that "involves a persistent feeling of anxiety or dread that interferes with how you live your life," according to the National Institute of Mental Health.

In California, Debbie Paperman, who is in her 40s, said she struggled with anxiety for at least two decades before being diagnosed with an anxiety disorder.

"Everyone's anxiety is different, but I think too many people think anxiety is something you just have to blow off and not think it's something to address," Paperman told ABC News. "A lot of times, people think anxiety is something that is happening because of something and not just because it's part of your brain structure."

Anxiety is the feeling evoked when someone experiences fear of something bad happening, and it can lead to avoidance, panic attacks, excessive worrying or other symptoms. Anyone can have anxiety at times, but when anxiety becomes overwhelming to the point that it consistently interferes with daily life, it can be an anxiety disorder, according to the National Institute of Mental Health.

In the United States, anxiety disorders affect as many as one in five adults, data shows.

Now, for the first time, a panel of national medical experts has recommended that adults under age 65 get screened for anxiety during routine medical visits.

The draft recommendations issued last week by the U.S. Preventive Services Task Force call on physicians to use standardized anxiety screenings like existing questionnaires to assess whether patients may have some of the signs and symptoms of anxiety.

The recommendations are intended as one way to help prevent mental health conditions from going undetected, according to Lori Pbert, Ph.D., a clinical psychologist and University of Massachusetts Chan Medical School professor, who serves on the task force.

"What we found was that screening for anxiety in adults younger than 65, including people who are pregnant and postpartum, can help identify anxiety early so people can be connected to the care they need," Pbert told ABC News. "This recommendation is specifically for individuals who do not have a mental health diagnosis and are not showing recognized signs or symptoms of an anxiety disorder."

People who have signs and symptoms of anxiety should proactively reach out to a doctor for help, she added.

The first-of-its-kind anxiety screening recommendation is seen as of particular importance to women, who suffer from anxiety disorder at greater rates than men, according to the National Institute of Mental Health.

Women are more than twice as likely as men to get an anxiety disorder in their lifetime, according to the U.S. Office on Women's Health. Risk factors for anxiety disorders can include genetics, hormonal changes and traumatic events, according to the office.

All three women who spoke with ABC News about their anxiety disorders said they struggled with not having a diagnosis of anxiety for so many years.

All said they believe they would have benefited if their primary health doctors had asked about their mental health, anxiety in particular.

"I definitely would have appreciated at the ages of 13, 14, 15 or in my 20s, a screening and then a referral to resources that I could access," said Hughes, now executive vice president of communications at Mental Health America, a nonprofit organization that supports mental health advocacy, education and research. "I definitely would have benefited from coping skills and some different framing in my mind of my anxiety and how it affects me."

Paperman, of California, put it more simply, saying of her decadeslong wait for a diagnosis, "It shouldn't have taken this long."

Why women suffer from anxiety disorders at a higher rate than men is a discrepancy not yet completely understood from a medical perspective. Some experts say it may be due, in part, to women's changing hormones during their menstrual cycle and reproductive years, and women may report symptoms of anxiety more frequently than men.

"I don't know that anybody has clear evidence," said Dr. Beth Salcedo, past president of the Anxiety and Depression Association of America and medical director of The Ross Center, a mental health treatment center. "With women's reproductive changes, they're a little bit more likely to see anxiety or mood disorders show up, but nobody really has an idea why it's different among the sexes from a biological perspective."

Salcedo, a practicing psychiatrist, said she applauds the task force's recommendation for more frequent and accessible anxiety screenings, but said it's only a first step in the process of getting care to people who need it.

"It's a value-add overall, but the medical system needs to change to be able to manage these things," Salcedo said. "If the government was willing to put a trained clinician in every one of these offices to look at the screens and evaluate the patients and make recommendations for therapy and give access to good treatment, that would be ideal, but that's not what this is, unfortunately."

Pbert said that with the recommendation that doctors include anxiety screenings in appointments, the hope is that people who may have vague symptoms they don't recognize as anxiety can be helped early.

Symptoms of anxiety disorders can include physical symptoms like restlessness, fatigue and even sometimes chest discomfort or trouble breathing, as well as mental symptoms such as fear and dread about things that may happen, according to the Office on Women's Health.

"Screening for anxiety disorders is not the only step. It's the first step," Pbert said, adding that if a person shows signs of an anxiety disorder on the screener, "they then can be linked up with appropriate treatment and follow-up care."

Pbert said the task force's recommendation will not be finalized until after the panel reviews public comments, which could take several months.

While the task force's recommendation would not be mandatory for doctors, it carries enormous weight in the medical community and its recommendations often change the way doctors practice medicine.

What to know about anxiety disorders

Like most mental health conditions, anxiety falls on a spectrum, with differing degrees of severity.

There are four main types of anxiety disorders.

Generalized anxiety disorder, or GAD, is described as worrying "excessively about ordinary, day-to-day issues, such as health, money, work, and family," according to the OWH. Women with GAD may be anxious about just getting through the day, may have difficulty doing everyday tasks and may have stress-related physical symptoms, like difficulty sleeping or stomachaches, according to the Office on Women's Health.

Panic disorder, also twice as common in women as in men, may see people having panic attacks, described by the Office on Women's Health as "sudden attacks of terror when there is no actual danger." People having panic attacks may feel like they're having a heart attack, dying or losing their minds.

A third type of anxiety disorder, social anxiety disorder, is diagnosed when people "become very anxious and self-conscious in everyday social situations," including embarrassing easily, according to the Office on Women's Health. People with social anxiety disorder can often have panic attack symptoms around social situations.

The fourth type of disorder, specific phobia, is an intense fear of something, such as heights, water, animals or specific situations, that possess "little or no actual danger," according to the Office on Women's Health.

Each type of anxiety disorder can bring with it different symptoms, but they all involve a "fear and dread about things that may happen now or in the future," according to the Office on Women's Health.

Treatment for anxiety disorders often includes a combination of counseling and medication -- and both together are often most effective.

When it comes to counseling, cognitive behavioral therapy (CBT) is often used to help people change thinking patterns around their fears, according to the Office on Women's Health. With medication, a prescription medication to treat and prevent future episodes of anxiety on a long-term basis is different than a medication such as Xanax or Valium that is intended for infrequent treatment of acute anxiety.

Treatment options for anxiety are shown here.

Other factors such as physical activity, nutrition and mindfulness can also play a role in coping with anxiety, although less is known about the role they play in treating anxiety disorders, according to the National Center for Complementary and Integrative Health, an entity of the National Institutes of Health (NIH).

Melissa Presser, a mom of three in south Florida, said it took a combination of many therapies for her to learn how to cope with the anxiety she said she's lived with for much of her life.

"Exercises that are quieting the mind, that has been a big part of my healing," said Presser, also an attorney and writer. "Another big part of my recovery has been a peer group. That was so overwhelmingly helpful, to sit with peers who were also suffering to varying degrees."

Presser said she has learned that anxiety disorders are not a condition you can diagnose by looking at someone, which is why she said it's important for doctors to talk with patients about the condition and empower them to get care.

"People who suffer from anxiety, you would never know it for most people from the outside," she said. "If you saw me on the street, you'd have no idea that I was suffering. I'm a person who functions with anxiety."

Copyright © 2022, ABC Audio. All rights reserved.


Young women take to social media to share breast cancer diagnoses, raise awareness

David Espejo/Getty Images

(NEW YORK) -- Women in their 20s and 30s are taking to social media to share their breast cancer diagnoses and raise awareness of breast cancer in women under 40.

"They're just starting their careers. They're starting their families," said Dr. Margaret Thompson, a doctor in breast services at Cleveland Clinic Florida. "They have their whole life ahead of them."

The American Cancer Society recommends that women ages 50 to 54 should have annual mammography exams and women over 55 should be screened every two years or once a year.

Since it may be more difficult to diagnose breast cancer for women younger than 40, two young women told "Good Morning America" that discovering their cancer could have meant the difference between life and death.

Entrepreneur Diamonique Valentine was 27 when she first shared her diagnosis on Instagram. Since her diagnosis, she's posted her breast cancer journey to thousands of viewers. Valentine said she never thought that having cancer was something that could happen to her.

"That moment I was diagnosed it was like, 'You have cancer. OK, you're gonna die,'" said Valentine, who said she was prompted to go to the doctor after she found a lump on her breast.

Valentine was diagnosed with stage 3 triple-negative breast cancer (TNBC), a cancer that is considered aggressive because it grows quickly, according to the American Cancer Society.

Additionally, Black women under 40 were more likely to be diagnosed with breast cancer than white women, according to a study published in the Journal of Surgical Research. Black women under 65 were also found to have a higher risk of death from breast cancer than white women.

Each year in the United States, the CDC reports that about 264,000 cases of breast cancer are diagnosed in women and about 2,300 in men.

Alexis Howerin was a 21-year-old college student when she was diagnosed with stage 2 cancer after she had found a lump on her breast.

"It was definitely gut-wrenching. The only thing that I knew about cancer was it took my grandmother's life," Howerin said. "So immediately, I thought ... 'Oh, my life is pretty much over.'"

Like Valentine, Howerin also uses her online platform to document what breast cancer looks like to her.

One in eight women born in the United States will develop breast cancer at some point in their life, according to the National Institutes of Health.

Although the risk for breast cancer in young women remains low, breast cancer found in young women can be more aggressive and more difficult to treat, according to Thompson, who treats women of all ages.

"In younger age women, the biology of the tumor tends to present with more aggressive features, compared to postmenopausal women," Thompson said.

Breast cancer can also be more difficult to spot in young women. Younger breast tissue tends to be dense so spotting tumors, even on mammograms, can be more challenging and may be misdiagnosed, according to the Cleveland Clinic.

Valentine said she believes if she had been a better self-advocate, she could have been diagnosed with breast cancer sooner.

"I wish that I would have advocated a little bit more and was a little bit more diligent in finding someone who would screen me with no insurance," Valentine said.

Both Valentine and Howerin are now cancer-free and focused on raising awareness around self-breast exams, especially for young women.

They are also both looking forward to the next years of their lives.

"I always dreamt of being a mother. ... One of my biggest goals in life is to have my own kids," said Howerin, who had frozen her eggs because harsh cancer treatment may pose a risk of infertility.

Valentine, who also wanted to be a mother, said she and her husband hoped for the best.

In May, they gave birth to a baby named Mali.

"He's everything that me and my family needed. He is like the reward after the storm," she said. "Nothing makes me more grateful."

Copyright © 2022, ABC Audio. All rights reserved.


Dozens of brie, camembert products recalled amid listeria outbreak

Image Source via Getty Images

(NEW YORK) -- More than two dozen brands of cheese have been recalled in connection with a listeria outbreak that has left multiple people hospitalized, federal officials said.

Old Europe Cheese recalled 25 brands of brie and camembert on Friday amid a multistate outbreak of listeria monocytogenes infections that have been linked to the products, the Centers for Disease Control and Prevention said.

Six people have been infected, with five requiring hospitalization, said the CDC, which is investigating the outbreak. No deaths have been reported. Those infected live in California, Georgia, Massachusetts, Michigan, New Jersey and Texas.

Four of the patients reported eating brie or camembert prior to their illness. An analysis of environmental samples taken from Old Europe Cheese's Michigan facility showed the presence of a listeria strain that matched the strain causing illnesses in the current outbreak, the Food and Drug Administration said.

Old Europe Cheese has voluntarily recalled the brie and camembert cheeses produced at the facility and is working with the FDA "on corrective actions," the agency said.

The recalled products include best-by dates ranging from Sept. 28, 2022, to Dec. 14, 2022, and include brands sold nationwide at multiple retailers such as Stop & Shop, Whole Foods, Sprout and Lidl.

A full list of recalled products can be found here.

"Investigators are working to determine if additional products may be contaminated," the CDC said.

Anyone with a recalled product is advised to throw it away and clean any surfaces and containers that may have come into contact with it.

Listeria can cause serious and sometimes fatal infections. Young children, those with weakened immune systems and the elderly are most at risk. Listeria infection can also cause miscarriages and stillbirths.

Symptoms include high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea. Anyone with symptoms of severe listeria illness after eating the recalled cheese should call their health care provider right away.

The recall comes after more than 87,000 pounds of various ready-to-eat meat products manufactured by Illinois-based Behrmann Meat and Processing were recalled due to possible listeria contamination.

The items were produced from July 7, 2022, to Sept. 9, 2022, and distributed in Illinois, Kentucky, and Missouri. There have been no confirmed reports of illness in connection with the products, the Department of Agriculture's Food Safety and Inspection Service said in a press release last week announcing the recall.

Copyright © 2022, ABC Audio. All rights reserved.


Pregnant Florida woman drives through Hurricane Ian to give birth

Health First’s Holmes Regional Medical Center

(MELBOURNE, FL) -- A pregnant Florida woman braved strong winds and potentially dangerous flooding to get to a hospital after she went into labor during Hurricane Ian.

Hanna-Kay Williams, from Melbourne -- about 70 miles southeast of Orlando -- started to experience contractions late Tuesday evening.

The area was already experiencing signs of the hurricane to come with fierce wind gusts and rain already coming down. Williams said she knew she was going to go into labor soon, so she, her fiancé and her mother drove through the treacherous conditions to Health First's Holmes Regional Medical Center.

"I don't even remember driving through the storm because I was in my own mental hurricane," she said in a news release.

They arrived at the hospital in the early hours of Wednesday morning, but Williams' delivery would not come quickly.

According to the release, Williams was in labor for more than 20 hours as Ian unleashed heavy rain and winds of more than 40 mph in the central part of the state.

Doctors decided a C-section was needed because Williams wasn't fully dilated and there were signs of fetal distress, which occurs when a fetus experiences changes in heart rate or shows signs of oxygen deprivation before or during labor.

Thanks to the medical care, Williams had a healthy baby girl named Wajiha at 10:11 p.m. ET, weighing 7 pounds 13 ounces and measuring 20 inches, after the C-section.

"Her name means beautiful woman, glorious, and she was phenomenal throughout the birthing process," Williams said.

After the difficult labor and severe weather, she said she and her family feel grateful Wajiha is doing well.

"We came out on top, we definitely did," Williams said in the release. "I felt when she first arrived and they sat her on my lap, the first thing I said was, 'That's a big baby' and then I looked at her and thought, 'That's my twin,' even though I already have a fraternal twin."

Williams said she thanks the nursing staff and everyone on the medical team for keeping her calm during the challenging childbirth.

"They made me feel like everything was going to be fine even through the hardest parts," she said. "They gave me so much love and care and for someone who works in the medical field, I know how important that is for patients."

After battering the southwestern coast, Hurricane Ian moved towards central Florida, bringing heavy flooding, resulting in people being rescued from homes, cars and even nursing homes.

In Orlando, a record rainfall of 12.5 inches was recorded in 24 hours. In New Smyrna Beach, about 50 miles northwest of Florida, 28.60 inches of rain fell in 27 hours.

During a news conference Thursday morning, Gov. Ron DeSantis said Central Florida was experiencing "a 500-year flood event."

As of Friday afternoon, nearly 2 million people are without power in the state, including more than 600,000 across Central Florida, according to poweroutage.us.

Copyright © 2022, ABC Audio. All rights reserved.


988 Suicide Prevention Lifeline sees 45% increase in contacts, but funding concerns remain

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(NEW YORK) -- Since the 988 Suicide & Crisis Lifeline launched on July 16, call centers have seen a 45% increase in contacts -- primarily in people texting or sending messages seeking help -- compared to last year, according to new data from the federal government's Substance Abuse and Mental Health Services Administration (SAMHSA).

"What we've seen is a big increase in text and chat, and some increase in phone calls," said Tim Jansen, chief executive officer for Community Crisis Services, Inc., in Hyattsville, Maryland. "Fortunately, [CCSI was] prepared. Answer rates have been really good nationally. The national waiting time has been reduced … It's still not where it needs to be, but it's significantly better."

988 is the new three-digit number for the service previously known as the National Suicide Prevention Lifeline, which had been operating with a ten-digit number since 2005. Prior to the launch of the new number -- touted as making the service more accessible -- advocates worried whether the system was appropriately funded and staffed to handle the anticipated spike in contacts from people in need.

The Lifeline has historically been underfunded and understaffed, the government has acknowledged. Ahead of the 988 launch and an anticipated increase in calls, $432 million in federal funding was invested in shoring up the system, enabling call centers across the nation to hire additional staff. But Jansen told ABC News that whether additional state funding is appropriated for the partner call centers in local areas across the country makes a difference.

"SAMHSA put some money in on the front end," Jansen said. "I think the SAMHSA funds have gotten everybody sort of off the mark and got everybody into the race. But it's got to be continued in order for things to move forward. Some states are going to do that easier than others."

Answer rate data from SAMHSA for the month of August, the first full month of implementation for 988, shows an 84% answer rate for calls, 97% for chats and 98% for texts. The answer rates for chats and texts represent a major increase compared to numbers released by SAMHSA in an appropriations report late last year, which showed a 30% answer rate for chats and 56% rate for texts through December 2020.

Jansen told ABC News that funding from the state of Maryland, in addition to the federal investments, made sure his facility was prepared. Many states, however, have offered no form of financial support for the system, though they were empowered by Congress in 2020 to enact cell phone taxes to fund the call centers, similar to how 911 call centers are funded.

Health and Human Services Secretary Xavier Becerra has been traveling across the country as part of HHS' National Tour to Strengthen Mental Health.

Earlier this month, he touted the Biden administration's investment in 988, saying in a statement: "Our nation's transition to 988 moves us closer to better serving the crisis care needs of people across America."

"988 is more than a number, it's a message: we're there for you," he added. "The transition to 988 is just the beginning. We will continue working towards comprehensive, responsive crisis care services nationwide to save lives."

Advocates for those in crisis, however, worry about the long-term of funding for the system given the uncertainty of future federal investment -- with shifting politics and shifting priorities -- and, so far, a lack of widespread monetary backing from states.

"We're going to need continued investment," said Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness. "One of my fears is that people are gonna think, 'OK, [the launch], came and went, our work is done.' There's so much more work to do. I keep saying we're closer to the starting line than the finish. But I think this is something that has a lot of momentum, but also is going to help millions of people and we can't lose sight of that."

Jansen, with the crisis center in Maryland, said that while "so far, [it's] been beautiful," a designated fund via a cell phone tax would also "make a huge difference."

That scenario would allow his facility to "focus a little less on the fundraising and a whole lot more on service delivery," he said.

Four states have passed cell phone taxes that would fund the 988 call centers year over year.

"There's only so much money, and folks prioritize what they see as important," Jansen said. "Hopefully everybody sees saving lives from suicide is important. I think they do. But you know, it always comes down to 'where does money get spent?'"

Since the launch of the new number, advocates cite another worry: Misinformation spreading online about 988 using personal information to track callers or send police without cause to the homes of those contacting the service -- which those involved say is an exaggeration.

"My biggest concern is that people will lose trust in the system just as it's getting off the ground and has the potential to help millions of people," said Wesolowski with the National Alliance on Mental Illness. "I am really fearful that somebody who could use that support and help is going to hesitate to call. We want every life saved. We want every person who's in emotional distress helped."

Call centers do have "imminent risk" standards by which they are required to send assistance to people who have contacted 988, though most calls do not reach that level, according to SAMHSA.

"It is important to note that fewer than 2% of calls to the 988 Lifeline require an emergency response, and most of those are done with the consent and cooperation of the caller," Dr. John Palmieri, acting director of SAMHSA's 988 and Behavioral Health Crisis Coordination Office, said in a statement. "We want anyone who calls, texts, or chats 988 to know that they are not required to provide any personal information to talk to a trained counselor."

Jansen noted that "every imminent risk policy underscores least invasive intervention as is possible. So you do the things that are the least invasive."

"Ninety-nine times out of 100, people are ready, willing and able to participate [with emergency personnel]," he said. "They don't call, they don't start a text or chat unless some part of them wants to live. So you have a little bit of an advantage."

Wesolowski noted that the concerns online of excessive intervention from 988 disproportionately impact marginalized communities, particularly communities of color.

"A lot of communities that are marginalized by our public systems and have seen kind of the worst results from this type of response when it's been available are skeptical, and it is completely reasonable that they are, given their past experience," Wesolowski said. "The exact people who can be best helped by 988 and and the system being built around it may not trust it enough to call, and I think that's incredibly concerning. That means more people aren't going to get the help they need and potentially many more lives lost."

Jansen also noted that making sure the 988 system works for everyone is important going forward.

"We've really got to look at suicide as sort of a more comprehensive or global issue. We've really got to be able to market in a way that we're getting into communities of color," he said. "And we've got to be getting in touch with them and making sure everybody can use 988 in a way that's culturally appropriate and appropriate to their community and all that sort of stuff. So there's some work to be done there in terms of outreach."

Jansen said the most important part of what his Maryland call center does is meet people "where they are" and start there to help them.

"988 is your three-digit dialing to mental health and crisis care systems," he said. "You are going to reach somebody who can help you right now that's going to be kind and educated enough to connect you appropriately, and most importantly, listen to you in terms of what your situation is."

If you are experiencing suicidal, substance use or other mental health crises please call or text the 988 Suicide & Crisis Lifeline. You will reach a trained crisis counselor for free, 24 hours a day, seven days a week. You can also go to 988lifeline.org.

Copyright © 2022, ABC Audio. All rights reserved.


Why young athletes may be more at risk for sudden cardiac arrest

ABC News

(NEW YORK) -- When 16-year-old Haley Meche stepped out onto the flag football field, she didn't know it would nearly kill her.

"My brain hurt so bad," Meche told ABC News' Good Morning America. "And then, like, everything went black."

Meche almost died from sudden cardiac arrest. She survived because she had known she had a heart condition and already had a defibrillator. Her doctors said that Meche's heart screening test detected her risk early -- and saved her life.

Studies have also shown that sudden cardiac arrest is the leading medical cause of death in athletes.

According to the Centers for Disease Control and Prevention, approximately 2,000 young people die from sudden cardiac arrest each year -- many without previously known heart issues.

"1 in 300 young persons has a condition at risk for sudden cardiac arrest," said Dr. Jonathan Drezner, the head of the UW Medical Center for Sports Cardiology in Washington, to GMA.

The risk is nearly four times higher in student athletes, according to Drezner. A risk that most athletes don't even know about, he said.

"Research shows that up to 80% of kids who suffer sudden cardiac arrest have no symptoms prior," said Drezner.

In Florida, non-profit "Who We Play For" is raising awareness around detecting risk earlier. They offer low-cost Electrocardiograms, or ECGs.

"It's never okay for a kid to die out of nowhere because they never know that they have a heart condition," said Meche.

Meche's school was one out of more than 150 schools in Florida that require student athletes to get an ECG before they play. Her doctors told her that early detection saved her life.

Similarly, Josh Tetteh was also able to detect a heart condition last year that, if gone unnoticed, could have led to sudden cardiac arrest.

He said he didn't have any symptoms so he wouldn't have known if it weren't for his preventative heart screening.

"My whole life was perfect," said Tetteh to GMA. "We had this screening, they found something within my heart that is one of the reasons why athletes die."

A majority of high schools across the country require student athletes to pass a thorough questionnaire endorsed by the American Heart Association (AHA) and a physical exam before playing sports. If a child is found at higher risk, guidelines call for additional testing and ECG.

Drezner said it's not enough.

"There is robust evidence that using that model for screening leaves the majority of kids at risk undetected," said Drezner.

The AHA told Good Morning America that it supports ECG testing for children at the highest risk, but stood by the current guidelines, which considers the latest research findings and patient safety.

The association also expressed concern that universal ECG screening may miss cases by de-emphasizing the importance of proper exams. Also, it would cost an estimated $2 billion that they said could be spent on other potentially life-saving interventions.

Dr. Eli Friedman, the medical director of sports cardiology at Miami Cardiac and Vascular Institute, agreed with the AHA guidelines and he advocated for other interventions.

"It's not a tool for everybody. The infrastructure is definitely a concern that I have because there's disparities in our healthcare system," said Friedman to GMA. "I advocate more than anything for emergency action planning, CPR and AED training."

The AHA said that it is an important area of study that needs more rigorous research and that there is concern that not all doctors are following screening guidelines.

As the debate continues, Bernadette Littles, Tetteh's mother, said she was grateful an ECG screening led to her son's diagnosis. She said she now volunteers to help other kids who may be in the same situation.

"After what happened to Josh, I volunteer. That's my way of saying thank you," she said to GMA. "Can't wait to go to Mayville State and watch him on the field."

Copyright © 2022, ABC Audio. All rights reserved.


What the new FDA 'healthy' definition means for food labeling, consumers

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(SILVER SPRING, Md.) -- Foods that claim to be "healthy" on their packaging will soon be subject to a new set of labeling guidelines, part of an effort by the U.S. Food and Drug Administration to help educate consumers on nutrition literacy and align packaging language with current nutritional guidance.

The FDA announced the new rules on Wednesday.

The proposed update will ensure that food labels with "healthy" content claims are better aligned with current nutrition science, the updated Nutrition Facts label and the current Dietary Guidelines for Americans.

For example, foods like salmon, despite having higher fat content, can now be labeled as "healthy," as it is a nutrient-dense food.

According to the FDA, "The proposed rule would update the 'healthy' claim definition to better account for how all the nutrients in various food groups contribute and may work synergistically to create healthy dietary patterns and improve health."

"Diet-related chronic diseases, such as cardiovascular disease and Type 2 diabetes, are the leading causes of death and disability in the U.S. and disproportionately impact racial and ethnic minority groups," FDA Commissioner Robert M. Califf, M.D., said in a statement on Wednesday. "Today's action is an important step toward accomplishing a number of nutrition-related priorities, which include empowering consumers with information to choose healthier diets and establishing healthy eating habits early. It can also result in a healthier food supply."

The moves by the FDA are part of a broader anti-hunger push from President Biden. The changes were announced ahead of the White House Conference on Hunger, Nutrition, and Health.

The FDA also plans move nutrition labels from the back to the front of a food package to help consumers "with lower nutrition literacy."

The newly proposed rule on healthy labels is part of the agency's ongoing commitment to help improve nutrition and dietary patterns for consumers to ultimately help reduce the burden of chronic disease and advance health equity.

According to the FDA, 80% of Americans don't eat enough vegetables, fruit and dairy, and most consume too much added sugars, saturated fat and sodium.

"Nutrition is key to improving our nation's health," HHS Secretary Xavier Becerra said in a statement. "Healthy food can lower our risk for chronic disease. But too many people may not know what constitutes healthy food. FDA's move will help educate more Americans to improve health outcomes, tackle health disparities and save lives."

Copyright © 2022, ABC Audio. All rights reserved.


Surge of respiratory illnesses in children straining some hospitals' capacity

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(NEW YORK) -- The surge in children's respiratory illnesses, including rhinovirus and enterovirus, is pushing pediatric emergency departments and health systems toward capacity in some parts of the country.

Infectious disease experts say they are seeing a higher-than-expected rate of certain pediatric infections other than COVID-19. There is no one reason for this uptick, but factors include time of the year and relaxed pandemic restrictions.

Hospitals across at least four states -- Washington, Louisiana, New Jersey and Massachusetts -- have told ABC News they are feeling this crush and expect things to worsen as the school year proceeds and winter approaches.

Seattle Children's Hospital is "experiencing unprecedented Emergency Department (ED) volumes and inpatient census," Dr. Tony Woodward, medical director of emergency medicine and Emergency Medicine Division chief at Seattle Children's, told ABC News in a statement.

There has been a particular upward trend in respiratory viruses, along with the background of COVID-19 and other standard viruses, Woodward said, adding that he expects the coming RSV and flu season to further amplify the trend.

"While we're still seeing some patients requiring hospitalization specifically with COVID-19, other respiratory and gastrointestinal illnesses are making our patients sick," Woodward said. "We are already seeing significant viral activity, which we expect to increase as kids are now back in school and the winter viral and flu season is approaching."

Enteroviruses can cause respiratory illness ranging from mild -- like a common cold -- to severe, according to the Centers for Disease Control and Prevention. In rare instances, severe cases can cause illnesses like viral meningitis (infection of the covering of spinal cord and brain) or acute flaccid myelitis, a neurologic condition that can cause muscle weakness and paralysis.

RSV -- or respiratory syncytial virus -- can also cause mild, cold-like symptoms, and in severe cases, can cause bronchiolitis or pneumonia, according to the CDC. "Most people recover in a week or two, but RSV can be serious, especially for infants and older adults," the CDC says.

Seattle Children's is seeing more than double the number of respiratory visits associated with the rise in rhinovirus than they have at any time in the past year -- statistically significant, Dr. Russell Migita, attending physician and a clinical leader of emergency services at Seattle Children's Hospital, told ABC.

They've also seen an early rise in RSV, Migita said. "In typical years, RSV starts to rise in November and peaks in February. Last year, it started in August. This year, September/October."

Woodward added that "wildfire smoke has also exacerbated respiratory and other health concerns for many children in the region."

In response to the recent emergency department surges, Woodward said the hospital has increased physician staffing and opened additional beds.

In an advisory to pediatricians and hospitals shared with ABC News, the New Jersey Department of Health warned of increasing levels of enterovirus and rhinovirus activity earlier this month, and noted the state is seeing a similar "surge" like other parts of the country.

A spokesperson for the department said they are "monitoring and watching hospitalizations and Pediatric Intensive Care Unit census daily throughout the state," adding that officials have planned a call with hospitals "to assess pediatric capacity" amid the surge.

Doctors at RWJ Barnabas Health System in New Jersey are seeing that upward trend in cases firsthand, where a wave of children's enterovirus cases in recent weeks has pushed their pediatric ICUs to capacity, Dr. Uzma Hasan, division director of pediatric infectious disease at Cooperman Barnabas Medical Center, told ABC News.

"Approximately two weeks ago we started to see the numbers steadily rising, and the ICUs were starting to hit capacity with these kids coming in with respiratory symptoms," Hasan said.

It has impacted asthmatic children and those with chronic lung disease particularly hard, but there have also been kids without any major underlying conditions who "seemed to have a pretty significant illness progress in a short period of time," Hasan added.

Children with chronic lung disease, premature babies and kids with asthma are considered especially high risk. Families of kids with asthma should have an action plan with how to deal with an asthma exacerbation if they become ill, Hasan said.

With regards to capacity, Hasan noted that staff had been in communication with state officials "to figure out which sites have ICU beds available to make sure these kids coming into the ER setting are getting accommodated."

One bittersweet silver lining of the pandemic, Hasan said, was how it had drilled hospitals and doctors on how to implement surge protocols and react to emergencies quickly, through COVID's many intense waves -- something has helped them handle the influx in respiratory cases of late. While hospitals are still understaffed and many doctors are grappling with burnout, they've been able to figure out ways to shuffle limited resources around where they're needed most, and how to stay nimble with shifting beds, patients and staff around fast.

"I think one good thing that came out of COVID -- if I can say that -- is we've learned to plan ahead of the game," Hasan said. "When we started seeing the numbers of patients showing up in the pediatric ERs rise and ICUs starting to fill up with kids, we got together pretty quickly to come up with a plan."

Still, that plan could be threatened as the country heads deeper into fall, flu season, and RSV season -- not to mention additional surges of COVID-19.

"The biggest worry is that we may see a concomitant rise in all these respiratory viruses -- and whether we will be able to accommodate the kids who are coming in with severe respiratory symptoms," Hasan told ABC. "We're bracing ourselves for what's next to come."

Ochsner Health in Louisiana is also seeing an "influx" of children's respiratory infections.

"Like other hospitals across the region and the country, Ochsner Health is currently experiencing an influx of viral pediatric respiratory illnesses," Dr. William Lennarz, pediatrics system chair of Ochsner Health, told ABC News in a statement.

"Our Emergency Department volumes have seen an increase due to the flu virus and other normal seasonal respiratory viruses like RSV," Lennarz said. "We are closely monitoring cases of respiratory illness and have a model in place to accommodate increased patient numbers and resources needed to care for these patients."

The Boston area, meanwhile, has seen a similar spike in pediatric respiratory illnesses.

"Reduced population-wide immunity, the dropping of COVID mitigation efforts and increased mixing in schools and daycares is likely responsible for driving the surge in pediatric cases of acute respiratory illness both in our region and nationally," Boston Children's Hospital chief innovation officer and ABC News contributor Dr. John Brownstein said, adding the challenges of emergency department and inpatient capacity, alongside staff shortage, are "only adding more fuel to this fire."

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Number of US suicides rose 4% in 2021, CDC report finds

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(ATLANTA) -- The number of suicides increased in the United States in 2021 after two consecutive years of declines, new federal data finds.

In 2021, there were 47,646 suicides, according to provisional data featured in the report, published Friday morning by the Centers for Disease Control and Prevention's National Center for Health Statistics.

This means there were about 14 suicides per 100,000 people.

The figure is a 4% rise from the 45,979 suicides that were recorded in 2020 and the rate of 13.5 per 100,000.

It comes after a 3.2% drop in suicides from 2018 to 2019 and a 1.7% drop from 2019 to 2020, the report found.

"Suicide is a major contributor to premature death in the United States," the authors wrote. "In the United States, suicide increased 35% from 1999 to 2018 before declining by 5% through 2020."

For the report, researchers looked at death certificate data from the NCHS as of May 15, 2022, looking at provisional data for 2021 and comparing it with final data for 2020 and earlier.

According to the report, the number of suicides per month in 2021 was only lower in January, February and July compared to 2020. For the other nine months, the number of suicides was higher.

The largest difference in monthly suicides occurred in October with an estimated 4,211 in 2021, which is an 11% increase from the 3,781 recorded in October 2020.

When looking at suicides broken down by sex, the number recorded for males in 2021 was 38,025, which is 4% higher than the 36,551 recorded in 2020.

Additionally, the rate of male suicides rose by 3% from 22.0 per 100,000 in 2020 to 22.7 per 100,000 in 2021, the report found.

Although female suicides increased by 2% from 9,428 in 2020 to 9,621 in 2021, researchers found that the rate increase from 5.5 per 100,000 in 2020 to 5.6 per 100,000 was not "statistically significant.

The report also found there were increases in suicide rates in nearly every age group.

Young adults saw the largest increase with 15-to-24-year-olds going from 14.2 suicides per 100,000 in 2020 to 15.3 per 100,000 in 2021.

Americans aged 35 to 44 had the second largest increase of 17.4 per 100,00 in 2020 to 18.2 per 100,000 in 2021.

The report did not go into explanations of why suicides increased, but studies have suggested the COVID-19 pandemic led to an increase in mental health challenges, particularly among children and teens, that may have led to a spike in suicides.

Researchers are also studying if there is a link between people with long COVID and higher rates of depression and suicidal thoughts.

If you are struggling with thoughts of suicide or worried about a friend or loved one, call the National Suicide Prevention Lifeline at 1-800-273-8255 [TALK] for free, confidential emotional support 24 hours a day, seven days a week.

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Thousands of people evacuated from Florida nursing homes, hospitals

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(NEW YORK) -- Thousands of nursing home residents and hospital patients across Florida have been evacuated in the aftermath of Hurricane Ian as the storm heads north.

As of Thursday afternoon, 45 nursing homes were evacuated -- impacting about 3,500 residents -- as were 115 assisted-living facilities, according to the Florida Health Care Association.

Kristen Knapp, senior director of strategy and communication for the FHCA, said most of the nursing homes "are in the low-lying areas where counties had issued evacuation orders."

"About 15 or 20 buildings are either running on full or partial generator power, but some of those are evacuated buildings so no one is in them," she told ABC News.

Under Florida law, generators must be able to provide four days' worth of power at assisted-living communities and nursing homes within 24 hours of a state of emergency being issued.

Evacuees are being transferred to nearby hospitals and shelters to wait out the storm while damages to buildings are being assessed.

Knapp said evacuators were taking steps to ensure elderly patients don't suffer transfer trauma -- which occurs when an elderly person experiences stress when changing living environments -- during this process.

"Evacuations always pose a concern about transfer trauma, we care for very frail elders who have complex medical needs, require oxygen, have Alzheimer's or dementia so we have to account for their mental health needs as well in the midst of an evacuation," she said in a statement.

As Ian moved into the central part of the state, dumping more than 16 inches of rain in a span of 24 hours, some nursing homes were left to evacuate under severe circumstances.

Orange County Fire Rescue shared photos and videos on Twitter Thursday morning of a rescue at Avante at Orlando, a nursing home about 10 miles north of Orlando International Airport.

Paramedics were pictured wheeling residents on stretchers and wheelchairs to waiting ambulances and buses.

Staff at the nursing homes used sandbags to soak up the anticipated rainfall, but it didn't stop water from seeping into the building.

"It was ankle deep when I walked in, but within a short time it was up to my waist," a member of the Fire Rescue team told ABC News.

The Orange County Sheriff's Office tweeted that in certain neighborhoods, flooding waters were "at least waist deep."

"Stay indoors. Stay sheltered," Sheriff John Mina said at a press conference Thursday afternoon. "There's a lot of standing water out there. We've had significant flooding throughout parts of Orange County...I'd encourage everyone to stay inside at this time."

Thousands of people were also evacuated from hospitals, especially in the battered southwestern part of the state.

At HCA Florida Fawcett Hospital in Port Charlotte -- about 30 miles northwest of Fort Myers -- the storm caused significant damage.

Storm surges led to flooding in the ground floor emergency room while powerful winds tore a section of the roof on the fourth floor, where the intensive care unit is located.

Mary Mahew, president and CEO of the Florida Hospital Association, said most hospitals did not suffer storm damage but one hospital system based in southwest Florida, Lee Health, will need to evacuate patients after being left without potable water.

"The biggest challenge is the lack of access to the public infrastructure with the utility, with the electrical grid down, they no longer have access to water," she told ABC News. "And that is what has forced them to deal with the evacuation of their patients because they cannot safely care for their patients without water."

Lee Health is currently evacuating about 1,000 patients to hospitals in neighboring regions.

Dr. Joseph Perno, vice president of medical affairs, at Johns Hopkins All Children's in St. Petersburg -- about 20 miles southwest of Tampa -- said the storm did not cause significant flooding in his area and the hospital is ready to accept any patients from other hospitals who were evacuated.

"We have been in contact with several hospitals and said, 'If you need us, we're here for you,'" he told ABC News. "We've been doing an inventory on our staff and our empty beds to see what we could handle if any of the hospitals south of us need help. We want to be ready to help them, so we're prepared to help not only our local community, but also the community most impacted by this terrible storm."

ABC News' Janai Norman and Gina Sunseri contributed to this report.

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Hundreds of hospitals on Atlantic and Gulf Coasts at risk of flooding as Ian hits Florida

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(NEW YORK) -- Hundreds of hospitals along the Atlantic and Gulf Coasts are at risk of flooding from hurricanes a new study finds, as Hurricane Ian made landfall in Florida Wednesday as a Category 4 storm.

The study, published Thursday, found that even lower category storms carry a serious risk to medical centers along the coasts.

Researchers from Harvard T.H. Chan School of Public Health, Boston University School of Medicine and nonprofit research institute PSE Healthy Energy looked at 682 hospitals in 78 metropolitan areas within 10 miles from the coast.

This covers an area where 85 million people -- or roughly one in four Americans --- live. Researchers found that in 25 of the 78 metro areas, at least half of the hospitals are at risk of flooding from a Category 2 hurricane.

Additionally, because of the rise in sea levels caused by climate change, hospitals are at a 22% higher risk of flooding.

Dr. Aaron Bernstein, senior author of the study and interim director of the Harvard Chan Center for Climate, Health and the Global Environment, told ABC News that this is the first study to examine what would happen to health care systems if they got hit by a hurricane.

"I [looked at the] literature and found that there was no literature on what hurricanes would systematically do to access to health care on the Atlantic or Gulf Coasts," he said. "There were papers showing the aftermath, so we have these studies after Katrina, after Sandy, after Harvey and those are very informative about what's at stake here."

He went on, "But no one had looked prospectively and said, 'OK, at a systems level, how do hurricanes matter to the ability of hospitals to be functional and deliver care at a time when people may need them more than usual?'"

Five of the 10 metro areas -- Tampa-St. Petersburg-Clearwater, Cape Coral-Fort Myers, North Port-Sarasota, Orlando-Kissimmee-Sanford, and Jacksonville -- will be tested by Ian.

The Sarasota area has the most hospitals at risk of flooding followed by the Fort Myers area.

Photos have been posted on social media of hospitals, such as Tampa General Hospital, preparing for storm surges from Hurricane Ian by building a flood barrier.

The other five metro areas include Miami-Fort Lauderdale-West Palm Beach, New York-Newark-Jersey City, Boston-Cambridge-Newton, New Orleans-Metairie and Philadelphia-Camden-Wilmington.

Additionally, the study found that even if hospitals themselves were not flooded, the roads around them may be, which could restrict or prevent access to care.

In 18 of the metro areas examined, at least half of all roads within one mile of hospitals were at risk of flooding due to a Category 2 hurricane.

"I think what our study underscores, and past experience does as well, is that while you could have a fully-functioning hospital in one part of a city, if you can't get there because the roads are underwater, it's not that helpful," Bernstein said. "So, we need to think more systematically in our response to hurricanes. It requires a coordinated response in metro areas about knowing where beds are, knowing where staff is available, where supplies can be accessed, knowing where transportation is safe."

Bernstein said the study gives an idea of which cities have hospitals that need to prepare against life-threatening flooding before it's too late.

"Most hospitals have done very little [to prepare for hurricanes] because they don't have the resources, which is understandable," Bernstein said. "Health care is on the ropes after COVID. So you can imagine the idea of building protections against flooding is not necessarily top on the priority list."

He continued, "With the risks of climate change, and hurricanes in particular, so grossly apparent, I don't think anyone wants to look back and say, 'Well, we let these people die.' I think we need to use the knowledge we can glean, to take informed steps that balance costs with outcomes."

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Hidden Epidemic: Schools, parents, police scramble as US fentanyl crisis worsens

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(NEW YORK) -- Twenty-year-old Charlie told ABC News' Nightline that he's lucky to be alive after he nearly became one of the thousands of people across the country who lost their lives to fentanyl.

The Southern California college student, who asked not to reveal his real name, was at a party in August when he thought he was taking a party drug, but it turned out to be the synthetic opioid. A friend was able to get help and quickly administered Narcan, a medicine used to reverse the effects of an opioid overdose, saving his life.

"Thank God that I was surrounded with the people that were there. Thank God my friends were there and thank God that I have smart friends," Charlie told Nightline.

Charlie's story is becoming all too common in America as parents, school officials and parents are scrambling to get ahead of the epidemic and prevent more deaths.

The U.S. Centers for Disease Control and Prevention said fentanyl was the leading cause of the record number of drug poisonings and overdose deaths in the country last year. More than 71,000 overdose deaths were linked to synthetic opioids like fentanyl, according to the CDC.

Local, state and federal law enforcement agencies have been on high alert, not only monitoring calls of overdoses but also stopping the flow of the drug into communities.

On Tuesday, the Department of Justice and U.S. Drug Enforcement Agency announced it seized an estimated 10 million fentanyl-laced pills and 82 pounds of fentanyl powder motor crews across all 50 states.

"That is enough to kill 36 million Americans," Attorney General Merrick Garland told reporters Tuesday.

Anne Milgram, U.S. Drug Enforcement Agency Administrator, told reporters Tuesday that two Mexican cartels, the Sinaloa Cartel and the Jalisco New Generation Cartel (JNGC), "are responsible for virtually all of the fentanyl and they currently dominate the worldwide fentanyl distribution and supply chain."

Another hurdle for authorities is brightly colored "rainbow fentanyl" pills that are the same as regular fentanyl but that could be mistaken for candy. They have been seized in at least 20 states since February, according to federal investigators.

Milgram added that agents are seeing fentanyl-laced pills disguised as regular drugs like OxyContin and Percocet.

Laura Brinker and Matt White, of San Diego, told Nightline that their 17-year-old son Connor White died last year from fentanyl poisoning when he thought he was taking Percocet.

"It was not a dozen pills in a bag. It was one pill…that was taken," Brinker told Nightline.

Brinker and her husband called for more awareness and education about the crisis.

"There's got to be other means and other ways that we're educating our children and in a very, very serious way, not just don't do drugs," she said.

Alberto Carvalho, the superintendent of the Los Angeles Unified School District, told Nightline that the crisis is getting worse in his schools.

"I cannot quantify it but I can tell it's much bigger, much more disturbing than what's reported," he said of the fentanyl crisis in Los Angeles schools.

Two weeks, ago 15-year-old Melanie Ramos was found dead on the floor of the girls bathroom after school hours from a fentanyl overdose. A 15-year-old boy, who is being investigated for allegedly selling her synthetic opioid, was arrested in connection with her death.

Days after Ramos' death, Carvalho announced that Narcan would be available at all K through 12 schools, and nurses and other staff will be trained on administering the drug.

"It's a sad new reality but consider the alternative. I think the presence of Narcan in our schools is a life-saving necessity at this point," he said.

In addition to the schools, non-profit groups have been hard at work spreading education on the dangers of fentanyl and providing tools to help prevent overdoses.

Madeline Hilliard, the founder of Team Awareness Combating Overdose (TACO), said her organization is also providing free test strips that can indicate if a drug is fentanyl in disguise. She said while there is some perception that the strips encourage more drug use, they save lives.

"What we see is when people use fentanyl test strips...they're now aware that fentanyl is a risk," Hilliard told Nightline.

Charlie, who is helping TACO with their awareness, said he too is urging young people to be cautious.

"It's inevitable that college students are going to come across these drugs. It's just becoming more and more integrated into drugs across the country," he said.

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New study confirms that COVID-19 vaccines can temporarily affect menstruation

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(NEW YORK) -- When COVID-19 vaccines became widely available, some women reported changes in the timing and length of their menstrual cycles after getting vaccinated.

Now, nearly two years later, a global study has confirmed that COVID-19 vaccination can lead to temporary changes in cycle length for some people.

The study, published in the medical journal BMJ, looked at nearly 20,000 women around the world who self-reported their menstrual cycle through Natural Cycles, an FDA-cleared birth control app.

Study participants who were vaccinated reported, on average, a nearly one-day day increase in the length of their menstrual cycle length after receiving their first COVID vaccine shot, and a half-day increase after receiving their second dose.

Participants who received both vaccine doses in a single menstrual cycle had a nearly four-day increase in cycle length

The study found, like other research has also shown, that the changes to cycle length are only temporary and do not have any long-term effects.

Earlier this year, a smaller study of around 4,000 women found similar results, reporting that a normal menstrual cycle returned within one or two months after getting vaccinated.

The two studies were launched thanks in part to the persistence of women who spoke out on social media and documented their side effects in an online database created by two researchers.

Several months later, in August 2021, the National Institutes of Health announced it was committing $1.6 million in funding to launch studies on the subject at five universities across the country.

Dr. Alison Edelman, professor of obstetrics and gynecology at Oregon Health and Science University School of Medicines, told ABC News earlier this year the research is important because it can help affirm women's anecdotal experiences and let them know what to expect after getting vaccinated.

"On a personal level, any noticeable change to a person’s cycle -- whether it be related to vaccination or other environmental stressors -- can indeed feel significant," said Edelman, a lead researcher on the two studies released so far. "As a clinician, I can help provide them with information about what to expect with vaccination, which might include a slight variation in their cycle length and have them prepared for this possibility so that they do not need to worry."

Menstrual changes are controlled by a part of the brain called the hypothalamus, along with the ovaries, which use hormones as signals. These hormone signals can be disrupted when the body goes through changes that occur with an infection and even a vaccine.

Getting vaccinated produces a strong immune system response in the days following the shot, which may cause temporary changes to menstrual cycles. Studies have also documented temporary menstrual cycle changes among women who get COVID-19 infections.

Temporary changes to the menstrual cycle should not be a concern for women, experts say. Changes lasting "three months consecutively, or more" are when health care providers typically make investigation or treatment plans, Dr. Jessica Shepherd, OBGYN and chief medical officer at Verywell Health, told ABC News last year.

Edelman and other experts say the findings that COVID vaccination can temporarily affect menstrual cycles do not mean the vaccine impacts current or future fertility.

In February, Dr. Anthony Fauci, the nation's top infectious disease expert, said there was "no evidence" that getting vaccinated against COVID-19 impairs fertility.

ABC News' Sony Salzman and Youri Benadjaoud contributed to this report.

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New guidance released on diagnosing, treating long COVID symptoms

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(WASHINGTON) -- Citing concerns about the lingering and sometimes debilitating long-term impacts of COVID-19 on the body -- and observed inequities amongst minority patients suffering disproportionately from the virus -- medical experts on “long COVID” issued the first guidance of its kind to diagnose and treat the mysterious illness.

Experts at the American Academy of Physical Medicine and Rehabilitation said they hope the guidance will help other doctors leverage their experience with patients to help address and mitigate their symptoms.

The guidance is indicative of widespread concern among medical experts that even months after resolving the initial infection, COVID is still causing serious health concerns amongst many Americans. At least 9 million long COVID patients are grappling with a range of symptoms, but experts said that number could be as high as 28 million people.

"When we recognized that long COVID, this new problem was developing due to the pandemic, we really felt an obligation to come forth and try to address it as best as we could," Dr. Steven Flanagan, American Academy of Physical Medicine and Rehabilitation president-elect said at a reporter roundtable Tuesday ahead of the guidance release. "We recognized two years ago, this is a problem."

A priority in addressing long COVID is to "recognize, assess and treat" the symptoms across a wide range of medical disciplines, including cardiovascular and pulmonary to neurologic, cognitive and gastrointestinal care, experts said.

Dr. Alba Azola, the lead author of the autonomic dysfunction guidance statement and member of the Johns Hopkins Post-Acute COVID-19 Team, said the medical community will need to tailor individual rehab protocols for each patient's unique needs.

"As the pandemic has continued, more people of all ages have contracted COVID-19, and the number of children potentially impacted by long COVID has also increased," Dr. Amanda Morrow, of Kennedy Krieger Institute’s Pediatric Post-COVID-19 Rehabilitation Clinic and lead author of the pediatric statement, said at the Tuesday media briefing.

The most common long COVID symptoms children experience are fatigue and attention problems, ongoing fever, headaches, sleep issues, and new mental health issues like anxiety and depression. Older, female children may be at an increased risk of developing long COVID, Morrow said.

Symptoms, management and rehabilitation for long COVID differ for children and adults, the experts said. Moreover, parsing out a long COVID diagnosis from other potential medical problems is not easy, since long COVID can involve so many of the body's systems.

"Parents, caregivers, teachers and coaches are the frontline in observing changes and children that may be related to long COVID," Morrow said.

"Children generally have fewer preexisting conditions than adults, so long COVID symptoms should be considered relative to the prior acute COVID illness," Morrow said. "Young children and children with disabilities may have difficulty describing their symptoms, so it's really important to try to tease that out during the medical interview."

ABC News asked how the new guidance will ensure marginalized communities get the attention they need. Making information about long COVID more accessible is a first step, the experts said, but it can't be the last.

"The Academy has been concerned about health equity, and we certainly want everybody to have access to the care that they need," Flanagan said. Though there is currently legislation aimed at supporting resources in underserved communities, "there is more to be done, and we are not there yet."

"This is a real significant issue," Azola said. "I think it's just the preponderance of Caucasian females in our cohorts of patients that are being treated at long COVID clinics is a reflection of the limited patient access to medical care in the United States, directly."

"We know that there are people out there, probably debilitated, suffering from long COVID symptoms, that are not even aware about long COVID, or that there's actually something that can be done to help them," Azola said.

ABC News' Anne Flaherty contributed to this report.

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Unvaccinated are 14 times more likely to get monkeypox, data from eligible shot recipients shows

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(WASHINGTON) -- New -- though limited -- data released on Wednesday morning from the Centers for Disease Control and Prevention found that people who haven't been vaccinated against monkeypox were 14 times more likely to get infected than vaccinated people.

The data is drawn from people who were eligible for a monkeypox vaccine in their states, which mostly includes men who have sex with men or people who have multiple sexual partners. The numbers provide the first sense of real-world effectiveness on the JYNNEOS vaccine, the leading inoculation against monkeypox.

"These new data provide us with a level of cautious optimism that the vaccine is working as intended," CDC Director Rochelle Walensky said in a White House briefing on monkeypox on Wednesday.

Dr. Demetre Daskalaskis, the monkeypox deputy response coordinator for the White House, urged people to share the "early good news."

"This knowledge is power -- and allows people to make more informed decisions about their health and build confidence in this important two dose vaccine," he said.

Real-world data on the JYNNEOS vaccine, initially designed to fight smallpox, has been limited since the start of the current outbreak

The Food and Drug Administration, the CDC and National Institutes of Health have -- largely at the behest of advocates in the LGBTQ community -- launched many studies on the JYNNEOS vaccine's safety and effectiveness since the outbreak began in May.

And though the new data is promising, Walensky also emphasized that it's just a glimpse. There are still outstanding questions about the full breadth of JYNNEOS' protection.

For example, the new efficacy rate of the vaccine was based on data gathered two weeks after the first vaccine, not after a full course of two shots, 28 days apart.

The CDC has yet to release data on efficacy after full vaccination, even though two shots is the consensus recommendation among federal public health officials.

"These early findings and similar results from studies in other countries suggest that even one dose of the monkeypox vaccine offers at least some initial protection against infection. That said, we know from laboratory studies that immune protection is highest two weeks after the second dose of vaccine," Walensky said on Wednesday.

"And it is for that reason that we continue, even in light of these promising data, to strongly recommend people receive two doses of JYNNEOS vaccine spaced out 28 days apart to ensure durable, lasting immune protection against monkeypox," she said.

More studies on efficacy after two shots are underway, Walensky said.

The CDC also has yet to differentiate the efficacy data between injection methods, which would provide further clarity on any potential differences between the new approach, where a smaller dose is injected just under the skin, and the original approach, where the injection was deeper.

It's also not clear how much of a role behavioral changes might be playing in the data on the vaccine's effectiveness.

If vaccinated people are reducing their sexual partners or chances for skin-to-skin contact, that could decrease their monkeypox infection rates, too.

Walensky pledged that more data is coming but that CDC is working to provide all the data it has in real time as soon as it is available -- a lesson learned from COVID-19.

"[The] CDC will continue to evaluate how these vaccines are working in the current outbreak through a portfolio of vaccine effectiveness projects that will help us understand the level of protection provided and how long that protection lasts. And we will continue to deliver these data to you as soon as we have them," Walensky said.

The CDC is also expanding eligibility for monkeypox vaccines to include more at-risk Americans -- though the JYNNEOS vaccine is still not recommended for the general population.

The expansion now includes gay or bisexual men who have had one partner in the last six months or received a new diagnosis of one or more sexually transmitted diseases in the last six months. It also includes sex workers.

Though many states and jurisdictions have already expanded eligibility, the CDC's latest move puts it in closer alignment with local guidance.

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